| NPI | 1740739242 |
|---|---|
| Former Name | AMANDA SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110007351) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2016-09-25 |
| Last Update Date | 2023-10-19 |